The health-related quality of life among survivors with post-COVID conditions in the United States

Abstract

Background Even after a mild initial SARS-CoV-2 infection, a considerable proportion of patients experience long-lasting symptoms. However, there is scarce data on how post-COVID conditions (PCCs) are associated with health-related quality of life (HRQL) among COVID survivors. We aimed to study this association among adult COVID survivors in the United States. Method The Behavioral Risk Factor Surveillance System 2022 data was utilized. The study population consisted of participants with a history of SARS-CoV-2 infection, categorized based on whether they had any PCCs. We evaluated the respondents’ HRQL in the two groups according to 1) self-reported general health (SRGH), 2) self-reported mental health, 3) self-reported physical health, and 4) efficiency in daily activities. Results A total of 108,237 COVID survivors were included (35% were 18–34 years old and 46.5% were male), among whom 22.7% had PCCs. Unfavorable SRGH was more common among COVID survivors with PCCs than those without PCCs (25.7% vs. 15.5%, p < 0.001). Also, rates of having unfavorable mental and physical health and compromised daily efficiency for more than 13 days a month were significantly higher among PCC-positive respondents (p < 0.001). In the regression analysis adjusted for sociodemographics, comorbidities, and behavioral determinants of health, the presence of PCCs appeared as independent associates of unfavorable SRGH (aOR: 1.39, CI95%: [1.28–1.52], p < 0.001). Among PCC-positive respondents, dizziness on standing, mood changes, and musculoskeletal pain accompanied the highest odds of unfavorable HRQL. Based on a multivariate logistic regression analysis, early middle age, obesity, physical inactivity, diabetes, cardiovascular and pulmonary diseases, cancer, depression, smoking, being single and less educated, and having low annual income were independent factors associated with increased odds of unfavorable SRGH among survivors with PCCs. Conclusion Our study corroborates that survivors with PCCs may experience significant adverse impacts on their health and daily life activities. Our results highlight the importance of further studies on PCCs’ diagnosis, follow-up, and treatment.